Nebivolol + Hydrochlorothiazide
Indications
Nebivolol + Hydrochlorothiazide is used for:
Hypertension
Adult Dose
Oral
Hypertension
Adult: Per tablet contains nebivolol 5 mg and hydrochlorothiazide 12.5 mg: 1 tablet once daily.
Child Dose
Renal Dose
Administration
Contra Indications
Hypersensitivity, liver impairment, anuria, sulphonamide allergy. Pregnancy, lactation.
Precautions
History of allergies, psoriasis, hyperthyroidism, peripheral arterial disease, diabetes, existing electrolyte disturbances, oedema, renal impairment, hyperlipidemia,hyperuricaemia. Elderly.
Pregnancy-Lactation
Interactions
Symptomatic hyponatraemia when combined with carbamazepine. Predisposes to allopurinol sensitivity reactions and impaired renal function. Potentiates hypotensive effect of beta blockers and ACE inhibitors; these also reduce diuretic-induced hypokalaemia.
Potentially Fatal: Enhance neuromuscular blocking action of competitive muscle relaxants. Cross-allergy with sulphonamides and sulphonylurea hypoglycaemics with resultant acute interstitial nephritis and vasculitis. Potentiates bone-marrow suppression caused by anticancer drugs. Potentiates aminoglycoside nephrotoxicity. Impaired control of diabetes by oral hypoglycaemic agents. May precipitate digitalis toxicity and lithium toxicity. Increased risk of hypokalaemia with corticosteroids. Prolongs paralysis caused by tubocurarine.
Side Effects
Side effects of Nebivolol + Hydrochlorothiazide :
Nebivolol - Headache, fatigue, parasthesias, dizziness.
Hydrochlorothiazide - Hypotension including orthostatic hypotension, pancreatitis, intrahepatic cholestatic jaundice, diarrhoea, vomiting, sialadenitis, cramping, constipation, gastric irritation, nausea, anorexia, thrombocytopenia, photosensitivity, fever, urticaria, rash, purpura, hyperglycemia, glycosuria, hyperuricemia, restlessness, impotence.
Potentially Fatal: Seizures, may unmask diabetes mellitus. Hyponatraemia and idiosyncratic, hypersensitivity reactions.
Mode of Action
Nebivolol exerts its actions by exhibiting a high selectivity for beta-1 adrenergic receptors and also by reducing the peripheral vascular resistance by modulating nitrous oxide release.
Hydrochlorothiazide inhibits the reabsorption of Na and chloride at the beginning of distal convoluted tubule. It causes natriuretic effect mainly by decreasing Na and chloride reabsorption in the cortical segment of the ascending limb of the Loop of Henle by inhibition of a specific Na+Cl- co-transporter.